Drug interactions
Fluticasone-salmeterol + Mitotane
Severity: Moderate
Fluticasone-salmeterol and Mitotane: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Mitotane is a strong CYP3A4 inducer that can substantially lower exposure to CYP3A4 substrates such as fluticasone. Inhaled fluticasone may become less effective and asthma or COPD control may worsen. Mitotane also causes adrenal suppression, so glucocorticoid status needs consideration.
What this interaction means in plain words
Fluticasone-salmeterol and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fluticasone-salmeterol belongs to Respiratory; Mitotane belongs to Oncology.
Why it happens
Induction of CYP3A4 by mitotane increases the metabolism of fluticasone and salmeterol.
What to do
Monitor respiratory control and consider a higher inhaled corticosteroid dose or an alternative less CYP3A4-dependent steroid if control is lost. Continue monitoring for weeks after mitotane is stopped, since induction persists.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fluticasone-salmeterol
- Darunavir + Fluticasone-salmeterol Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Fluticasone-salmeterol Contraindicated
- Fluticasone-salmeterol + Fosamprenavir Contraindicated
- Fluticasone-salmeterol + Indinavir Contraindicated
- Fluticasone-salmeterol + Lopinavir Contraindicated
- Fluticasone-salmeterol + Nelfinavir Contraindicated
Other interactions of Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Fluticasone-salmeterol with Mitotane?
MediHelp rates the interaction as moderate. Fluticasone-salmeterol and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Mitotane is a strong CYP3A4 inducer that can substantially lower exposure to CYP3A4 substrates such as fluticasone. Inhaled fluticasone may become less effective and asthma or COPD control may worsen. Mitotane also causes adrenal suppression, so glucocorticoid status needs consideration.
How serious is the interaction between Fluticasone-salmeterol and Mitotane?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor respiratory control and consider a higher inhaled corticosteroid dose or an alternative less CYP3A4-dependent steroid if control is lost. Continue monitoring for weeks after mitotane is stopped, since induction persists.
What other medicines interact with Fluticasone-salmeterol?
MediHelp also lists interactions of Fluticasone-salmeterol with, for example, Darunavir, Elvitegravir / cobicistat / emtricitabine / tenofovir df, Fosamprenavir. The full list is on the Fluticasone-salmeterol page.
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